Physical Aggression and Coronary Artery Calcification: A North Texas Healthy Heart Study

Kimberly G. Fulda, Karen L. Roper, Claude H. Dotson, Roberto Cardarelli

Research output: Contribution to journalArticlepeer-review


Background: The purpose of this study was to determine the association between aspects of hostility and coronary artery calcification (CAC) scores. Specifically, analyses differentiated between subtypes of hostility and their relation to CAC. Methods: A sample of 571 patients aged 45 or older with no history of cardiovascular disease completed assessments of demographic, psychosocial, and medical history, along with a radiological CAC determination. Logistic regression was used to determine the association between hostility and CAC. Hostility was measured using the Aggression Questionnaire, which measured total aggression and how aggression is manifested on four scales: Physical, Verbal, Anger, and Hostility Aggression. Results: Regression analyses indicated that only the physical aggression parameter was related to CAC: a 5% increase in odds of CAC presence was indicated for every point increase in physical aggression. The association remained significant in adjusted analyses. Other factors associated with CAC in adjusted analyses included: age, gender, race/ethnicity, BMI, and dyslipidemia. Conclusions: Psychosocial factors, such as physical aggression, are emerging factors that need to be considered in cardiovascular risk stratification.

Original languageEnglish
Pages (from-to)14-24
Number of pages11
JournalInternational Journal of Behavioral Medicine
Issue number1
StatePublished - Feb 2022

Bibliographical note

Funding Information:
We would like to acknowledge the efforts and support of the members and staff of the North Texas Primary Care Practice-Based Research Network (NorTex) who helped to make this project possible.

Funding Information:
The project described was supported by Grant Number P20MD001633 from the National Institute on Minority Health and Health Disparities and the NIH Loan Repayment Program. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Minority Health and Health Disparities or the National Institutes of Health.

Publisher Copyright:
© 2021, International Society of Behavioral Medicine.


  • Aggression
  • Atherosclerosis
  • Coronary artery calcification
  • Psychosocial

ASJC Scopus subject areas

  • Applied Psychology


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